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1989, 01-17 Permit App: 89000112 Furnace t MECHANICAL PERMIT-APPLICATION•WORKSHEET PLEASE.PRINT AND COMPLETE ONLY. Hy, SPA4(,RTS OF THE.FORM YOU UNDERSTAND( . f Project 0 / I/) Owner's Name Last First. _ MI I L L w 0(z.7,4�1.:: •L, z ' Project Address(Street Name&Number).' city State 8ubdlvldon Plat Name _ SPS C L1/4)Ar- A • coin , Assessors Parcel M o . Blodt' Ptat I / 5 - /1 '' .... . 2.-- Applicant , pplicant Address. r. ..FL.— . City State 1 . p`9, .?"4-7.--P ‘ -Ptwne I.Z-Y 6 7 g . , .1.....,,,!. Business Phone Contractor '• Addres,� i.) 9-/�� Phone y State v V � ,S---35----- /7// • Business Phone d Contact RU S LEst /J D F ..3License M"if,�/VE/f -37.( �/� ii Dasc•lbe Work 'F E-. 6 L t r C 0 L L- s eAle .,, Pans EvaporatiiveeCooler Hoods Electric Furnace/ducts Miscellaneous ' Gat Gas Water Htr. Solid Fuel/Wood Stove Dryer Range L• g`',. . 0.10,000 CFM 10,000+CFM Air Handling Units r aelrlgeratlon Systema/ •1-100M 101-500M 501-1,000M Meat Pumps(BTU) 1,001.1750M , Over 1750M O-3H P 3-15H P 1 S-30H P 30-50H P 50+HP Compressor 1-S Out1sU • 6+Outlets Gas Piping 1-1;10,C0001-U •• • •.'' • ' ' ' 1A'_.,�O0+BTl t Gas Fired Heating System ? Q Q Q I ` ':,2 • . . I certify that the above information as submitted by''me is-�true and.correct and further, agree that all pro- visions of laws and ordinances.governing this:type of-work; Including inspection requirements, will be com- plied with whether specified herein•or not: The granting:of a.permit does not presume to give authority to violate or cancel the provisions of any state of,'local laws regulating construction or the performance of Construction. • SIGNATURE OFfit. APPLICATION 1 — t �� 't OWNER OR DATE ,